The Clinical Research On Dupuytren's Contracture

It has been nearly 200 years since the Dupuytren's disease was reportedby Cooper for the first time ,but about the etiopathogenisis and the risk factorsof Dupuytren's disease there are still a lot of things need to be studied.Most ofthe cases of Dupuytren's disease now was therapied by operative treatment.Thepurpose of this article is to investigate the morbility of the Dupuytren's diseasethe resent years,to compare the therapeutic effect and the complications ofdifferent methods of operation with each other,and to make a further study onthe etiopathogenisis and the risk factors about the Dupuytren's disease.FromJanuary 1993 to January 2005 31 cases with the Dupuytren 's disease wereoperated and followed up.There are 4 methods of operation .The standard ofthe therapeutic effect : Excellent:the flexion contracture is improvedcompletely;Well: the flexion contracture is improved more than 75%;Passable:the flexion contracture is improved less than 75%;Badly : the flexioncontracture has no improve. Results: In this series of cases ,the proportion ofthe hands that stage 0~2 to stage 3~4 are 11:1(22/2) after 2000(2000involved) and 3:1(18/6) before 2000. The excellent and good rate of thepatients that undertaked partial resection of palmar fascia is 75.0%,the rate ofthe recurrence is 17.9%,the necrosis of the skin :1 hand,the anesth of thenerve:1 hand;The excellent and good rate of the patients that undertaked theentire resection of palmar fascia is 71.4%,the rate of the recurrence is 14.3%,thenecrosis of the skin :1 hand,the anesth of the nerve:2 hands, hematomaformation: 1 hand, postoperative infection:1 hand. The excellent and goodrate of the patients that were resected the palmar fascia and skin involved is83.3%,the rate of the recurrence is16.6%, the anesth of the nerve:2 hands. Theexcellent and good rate of the patients that were resected the palmar fascia andskin involved and undertaked the dermoplasty is 100%,there is no recurrence,the anesth of the nerve:1 hands, postoperative infection:1 hand.12 patients arefound of smoking and drinking.10 patients have the chronic disorder of therespiratory system,5 patients are found have the chronic disorder of thecardiovascular system,which affected oxyenic exchange. 3 patiewnts havehypertension,4 patients have the disorder of the digestive system, 2 person haverheumatoid arthritis ,3 patients have diabetes.The conclusion: 1.Dupuytren's disease now can be discovered in the initialstage and then be treated. 2.There is no distinguished difference in thetherapeutic effect between the resectingpartial resection of palmar fascia andthe entire resection of palmar fascia. Resecting the skin involved andundertaking the dermoplastywhen necessary may reduce the recurrence of theDupuytren's disease. 3. The relationship between Smoking and Drinking,and soon,with the morbility of the Dupuytren's disease is just as well as having beenreported before.